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Primary City/State:

Phoenix, Arizona

Department Name:

PFS Cash Applications

Work Shift:

Day

Job Category:

Revenue Cycle

POSITION SUMMARY

Responsible for the interpretation and accurate posting of all third-party/government payers’ payments, denials, and adjustments, as well as all patient and client payments. Also documents and reports payment issues and assists in payment issue resolution. Must have the ability to review and analyze all insurance explanations of benefits/payments and electronic remittance advices. Coordinates and facilitates account refunds, complex adjustments, and collection accounts. Researches and reconciles unapplied and/or missing payments. Requires the ability to interact with all levels of personnel and management.

CORE FUNCTIONS

1. Reviews and analyzes payer remittance advices, in order to report trends to management, as well as collaborate and meet with third-party/government reimbursement, as necessary, to facilitate resolution to outstanding payment issues requiring higher-level intervention.

2.Evaluate payer remits and denials for accurate posting and potential transfers to patient receivables. Evaluate accuracy of reimbursement relative to contractual requirements. Determines adjustment, corrections, or patient liability.

3.Reviews, evaluates, and posts all payments, denials and adjustments from manual and electronic insurance remittance advices, as well as client and patient payments in an accurate and timely manner in accordance with departmental policies, procedures and performance goals.

4.Researches and resolves missing, misdirected, and unidentified payments, as well as prepaid accounts. Coordinates transfers of misdirected payments to Quest Diagnostics Business Units.

5.Interprets and resolves written correspondence involving payment transfers, adjustments, credit balances, refunds and collection accounts. Documents requests for outside Collection agency.

6.Assist in Internal Audits and comply with checks and balances in accordance with departmental policies, procedures, generally accepted basic accounting principles and practices and all applicable laws and regulations.

KNOWLEDGE, SKILLS AND ABILITIES

+ Excellent organizational skills.

+ Ability to handle highly confidential information.

+ Ability to exercise independent judgment.

+ Demonstrated ability to set and maintain multiple priorities in an environment with shifting priorities, while providing accurate deliverables in a timely fashion.

+ Must be self-motivated and able to take ownership of projects/assignment.

+ Must be a team player.

+ Must have excellent customer service skills with outstanding follow-up.

+ Strong interpersonal, verbal and writing skills.

+ Knowledge of standard office equipment. Intermediate math, analytical and typing skills.

+ Ability to work independently and accurately with high volumes of data and minimal supervision.

MINIMUM QUALIFICATIONS

+ High school diploma/GED or equivalent working knowledge.

+ One (1) year of experience in patient financial services, financial/accounting, or healthcare insurance industry.

PREFERRED QUALIFICATIONS

+ Experience in reading and interpretation of patient Explanation of Benefits (EOBs).

+ Additional related experience.

EEO Statement:

EEO/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)

Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

https://www.bannerhealth.com/careers/eeo